U.S. patent application number 17/287439 was filed with the patent office on 2022-06-09 for total knee arthroplasty robot auxiliary system, control method and electronic device.
This patent application is currently assigned to TINAVI MEDICAL TECHNOLOGIES CO., LTD. The applicant listed for this patent is TINAVI MEDICAL TECHNOLOGIES CO., LTD. Invention is credited to Mingming DENG, Jiaqi HAN, Chunyan LIU, Hao TANG, Zhan WANG, Jin XU, Ziang Xu, Dejin YANG, Miao ZHANG, Yixin ZHOU.
Application Number | 20220175453 17/287439 |
Document ID | / |
Family ID | 1000006211628 |
Filed Date | 2022-06-09 |
United States Patent
Application |
20220175453 |
Kind Code |
A1 |
Xu; Ziang ; et al. |
June 9, 2022 |
TOTAL KNEE ARTHROPLASTY ROBOT AUXILIARY SYSTEM, CONTROL METHOD AND
ELECTRONIC DEVICE
Abstract
The present application provides a total knee arthroplasty robot
auxiliary system, a control method, electronic device and a
computer readable medium. The auxiliary system comprises: a
preoperative planning system configured to formulate a preoperative
plan, preoperative plan data including a knee joint image; an
intraoperative planning system configured to formulate an
intraoperative plan, wherein the knee joint image in the
preoperative plan and a knee joint surface contour of the patient
determined in an operation are subjected to image registration,
knee joint dynamic spacing force line data at a continuous
flexion-extension angle is acquired, a dynamic spacing force line
data graph is visually displayed, and a prosthesis plan is adjusted
according to the visual display of the dynamic spacing force line
data graph to obtain the intraoperative plan; and an executing
system, wherein a bone-cutting guide mounted at an operating end of
a mechanical arm of a surgical robot is guided to be located in a
planned predetermined position according to the intraoperative
plan, and the bone-cutting guide is configured to locate a
bone-cutting saw.
Inventors: |
Xu; Ziang; (Beijing, CN)
; LIU; Chunyan; (Beijing, CN) ; WANG; Zhan;
(Beijing, CN) ; HAN; Jiaqi; (Beijing, CN) ;
DENG; Mingming; (Beijing, CN) ; ZHANG; Miao;
(Beijing, CN) ; XU; Jin; (Beijing, CN) ;
ZHOU; Yixin; (Beijing, CN) ; YANG; Dejin;
(Beijing, CN) ; TANG; Hao; (Beijing, CN) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
TINAVI MEDICAL TECHNOLOGIES CO., LTD |
Haidian District, Beijing |
|
CN |
|
|
Assignee: |
TINAVI MEDICAL TECHNOLOGIES CO.,
LTD
Haidian District, Beijing
CN
|
Family ID: |
1000006211628 |
Appl. No.: |
17/287439 |
Filed: |
November 16, 2020 |
PCT Filed: |
November 16, 2020 |
PCT NO: |
PCT/CN2020/129132 |
371 Date: |
April 21, 2021 |
Current U.S.
Class: |
1/1 |
Current CPC
Class: |
A61B 17/154 20130101;
A61B 2034/104 20160201; A61B 2034/2055 20160201; A61B 34/20
20160201; A61B 2017/565 20130101; A61B 34/25 20160201; A61F 2/38
20130101; A61B 2034/2065 20160201; A61B 2034/108 20160201; A61B
34/10 20160201; A61B 2034/2068 20160201; A61B 2034/105 20160201;
A61B 34/30 20160201 |
International
Class: |
A61B 34/10 20060101
A61B034/10; A61B 17/15 20060101 A61B017/15; A61B 34/20 20060101
A61B034/20; A61B 34/00 20060101 A61B034/00; A61B 34/30 20060101
A61B034/30; A61F 2/38 20060101 A61F002/38 |
Foreign Application Data
Date |
Code |
Application Number |
Mar 13, 2020 |
CN |
202010177303.6 |
Claims
1. A control method of a total knee arthroplasty robot auxiliary
system, comprising: generating a preoperative plan, wherein
preoperative plan data comprises an image of a patient knee joint;
generating an intraoperative plan, comprising: performing image
registration on the knee joint image in the preoperative plan and a
knee joint surface contour of the patient determined in an
operation; acquiring knee joint dynamic spacing force line data at
a continuous flexion-extension angle; visually displaying a dynamic
spacing force line data graph; and adjusting a prosthesis plan
according to the visual display of the dynamic spacing force line
data graph; and controlling operation of a surgical robot according
to the adjusted prosthesis plan and guiding a bone-cutting guide to
be located at a planned predetermined position, wherein the
bone-cutting guide is mounted at an operating end of a mechanical
arm of the surgical robot to locate a bone-cutting saw.
2. The control method according to claim 1, wherein the acquiring
knee joint dynamic spacing force line data at a continuous
flexion-extension angle comprises: acquiring motion track
information of the knee joint in the continuous lower limb
flexion-extension process; and calculating a spacing and a force
line angle at a continuous lower limb flexion-extension angle
according to the motion track information.
3. The control method according to claim 2, wherein the adjusting a
prosthesis plan comprises: receiving prosthesis position adjusting
information interacted by a user; and recalculating a spacing force
line and refreshing the dynamic spacing force line data graph.
4. The control method according to claim 3, wherein the prosthesis
position information comprises at least one of a varus/valgus
angle, an external/internal rotation angle, a front and back
inclination angle, a vertical translation distance or a transverse
translation distance.
5. The control method according to claim 1, further comprising:
visually adjusting the preoperative plan before generating the
intraoperative plan.
6. The control method according to claim 1, further comprising:
before controlling operation of the surgical robot according to the
adjusted prosthesis plan, simulating guiding the mechanical arm in
a man-machine interaction interface, so that the bone-cutting guide
arrives at the planned position and a through groove of the
bone-cutting guide is aligned with a corresponding bone-cutting
plane.
7. The control method according to claim 1, further comprising:
before controlling operation of the surgical robot according to the
adjusted prosthesis plan, selecting one bone-cutting plane from a
plurality of bone-cutting planes, wherein the plurality of
bone-cutting planes comprise a first bone-cutting plane, a second
bone-cutting plane, a third bone-cutting plane, a fourth
bone-cutting plane, a fifth bone-cutting plane and a sixth
bone-cutting plane; and controlling the mechanical arm according to
the prosthesis plan, so that a through groove of the bone-cutting
guide is aligned with the selected bone-cutting plane and the
bone-cutting guide is located at a corresponding planned
position.
8. The control method according to claim 7, further comprising:
updating prosthesis plan data; selecting another bone-cutting plane
from the plurality of bone-cutting planes; and guiding the
mechanical arm according to the updated prosthesis plan data, so
that a through groove of the bone-cutting guide is aligned with
another selected bone-cutting plane and the bone-cutting guide is
located at a corresponding planned position.
9. The control method according to claim 7, wherein the first
bone-cutting plane, the second bone-cutting plane, the third
bone-cutting plane, the fourth bone-cutting plane, the fifth
bone-cutting plane and the sixth bone-cutting plane are
respectively one of a tibial distal-end bone-cutting plane, a
femoral distal-end bone-cutting plane, a femoral front-condyle
oblique bone-cutting plane, a femoral rear-condyle oblique
bone-cutting plane, a femoral front-condyle bone-cutting plane and
a femoral rear-condyle bone-cutting plane.
10. A total knee arthroplasty robot auxiliary system, comprising: a
preoperative planning system, configured to formulate a
preoperative plan, wherein preoperative plan data comprises an
image of a patient knee joint; an intraoperative planning system,
configured to formulate an intraoperative plan, wherein the knee
joint image in the preoperative plan and a knee joint surface
contour of the patient determined in an operation are subjected to
image registration, knee joint dynamic spacing force line data at a
continuous flexion-extension angle is acquired, a dynamic spacing
force line data graph is visually displayed, and a prosthesis plan
is adjusted according to the visual display of the dynamic spacing
force line data graph to obtain the intraoperative plan; and an
executing system, wherein a bone-cutting guide mounted at an
operating end of a mechanical arm of a surgical robot is guided to
be located in a planned predetermined position according to the
intraoperative plan, and the bone-cutting guide is configured to
locate a bone-cutting saw.
11. The auxiliary system according to claim 10, wherein the
preoperative planning system and the intraoperative planning system
are arranged in an upper controller, the executing system is
arranged in the surgical robot, and the upper controller transmits
the intraoperative plan to the surgical robot, so that the surgical
robot can execute corresponding operation according to the
plan.
12. The auxiliary system according to claim 11, wherein the
intraoperative planning system comprises a positioning system, the
positioning system comprises a femur tracer, a tibia tracer and a
navigation camera, wherein the femur tracer and the tibia tracer
are respectively arranged at a femur and a tibia of a knee joint of
a patient, and the navigation camera cooperates with the femur
tracer and the tibia tracer to acquire and record motion track
information of the knee joint in the continuous lower limb
flexion-extension process; and the upper controller is in
communication connection to the femur tracer, the tibia tracer and
the navigation camera, and is configured to acquire a spacing and a
force line angle at a continuous lower limb flexion-extension angle
according to the motion track information so as to acquire knee
joint dynamic spacing force line data at the continuous
flexion-extension angle.
13. The auxiliary system according to claim 12, wherein the
positioning system further comprises a scanning probe with a
scanning tip arranged at one end thereof for scanning the knee
joint of the patient and a plurality of tracing components arranged
at the other end thereof, wherein the plurality of tracing
components are identified by the navigation camera to acquire a
motion track of the scanning tip; and the upper controller is in
communication connection to the scanning probe and the navigation
probe, and the upper controller is configured to acquire knee joint
surface contour data according to the motion track of the scanning
tip and perform image registration on the knee joint image in the
preoperative plan and the patient knee joint surface contour
acquired during operation.
14. The auxiliary system according to claim 13, wherein the femur
tracer cooperates with the navigation camera to acquire and record
position information of the knee joint; and the upper controller is
configured to formulate the intraoperative plan according to
position data of the knee joint.
15. The auxiliary system according to claim 14, wherein the
positioning system further comprises a bone-cutting guide tracer
mounted at an operating end of the mechanical arm, wherein the
bone-cutting guide is detachably mounted on the bone-cutting guide
tracer, and the navigation camera cooperates with the bone-cutting
guide tracer to acquire and record position information of the
bone-cutting guide; and wherein the upper controller is in
communication connection to the bone-cutting guide tracer and the
navigation camera, and is configured to formulate the
intraoperative plan according to position data of the bone-cutting
guide.
16. The auxiliary system according to claim 14, wherein the upper
controller comprises a man-machine interaction device for
displaying the dynamic spacing force line data graph and displaying
adjustment of the prosthesis plan in response to user
operation.
17. The auxiliary system according to claim 10, wherein the
bone-cutting guide comprises a first through groove and a second
through groove intersected with the first through groove, and the
through grooves are configured to accommodate the bone-cutting
saw.
18. The auxiliary system according to claim 16, wherein the upper
controller is configured to: select one bone-cutting plane from a
plurality of bone-cutting planes respectively in response to
operation of a user using the man-machine interaction device in
respective stages of the arthroplasty, the plurality of
bone-cutting planes comprising a first bone-cutting plane, a second
bone-cutting plane, a third bone-cutting plane, a fourth
bone-cutting plane, a fifth bone-cutting plane and a sixth
bone-cutting plane; and transmit the intraoperative plan comprising
the selected bone-cutting plane information to the surgical robot;
wherein the surgical robot controls the mechanical arm to move
according to the intraoperative plan, so that the through groove of
the bone-cutting guide is aligned with the selected bone-cutting
plane and the bone-cutting guide is located at a corresponding
planned position.
19. The auxiliary system according to claim 18, wherein the upper
controller is further configured to: update prosthesis plan data is
updated to acquire a new intraoperative plan; select another
bone-cutting plane from the plurality of bone-cutting planes in
response to operation of a user using the man-machine interaction
device; transmit the intraoperative plan comprising the selected
another bone-cutting plane information to the surgical robot;
wherein the surgical robot controls the mechanical arm to move
according to the intraoperative plan, so that the through groove of
the bone-cutting guide is aligned with the selected another
bone-cutting plane and the bone-cutting guide is located at a
corresponding planned position.
20. The auxiliary system according to claim 18, wherein the first
bone-cutting plane, the second bone-cutting plane, the third
bone-cutting plane, the fourth bone-cutting plane, the fifth
bone-cutting plane and the sixth bone-cutting plane are
respectively one of a tibial distal-end bone-cutting plane, a
femoral distal-end bone-cutting plane, a femoral front-condyle
oblique bone-cutting plane, a femoral rear-condyle oblique
bone-cutting plane, a femoral front-condyle bone-cutting plane and
a femoral rear-condyle bone-cutting plane.
21. The auxiliary system according to claim 10, wherein a tracer is
mounted on the bone-cutting saw.
22. The auxiliary system according to claim 10, wherein a strain
gauge is mounted at a free end of the bone-cutting saw.
23. The auxiliary system according to claim 15, wherein the
bone-cutting guide tracer is an annular tracing device.
24. The auxiliary system according to claim 15, further comprising
a knee joint fixing device arranged on an operating table to fix
the knee joint of the patient.
25. The robot auxiliary system according to claim 16, wherein the
man-machine interaction device comprises a display screen
comprising a first window for displaying a knee joint
three-dimensional image and a second window for displaying knee
joint dynamic gap force line data, wherein the first window is
associated with the second window, so that when the first window
adjusts prosthesis position information, the second window displays
a knee joint dynamic gap force line graph at the position.
26. The robot auxiliary system according to claim 25, wherein the
prosthesis position information comprises at least one of a
varus/valgus angle, an external/internal rotation angle, a front
and back inclination angle, a vertical translation distance and a
transverse translation distance.
27. The auxiliary system according to claim 25, wherein a
flexion-extension angle is selected in the second window, the knee
joint dynamic gap force line graph at the current angle is
displayed, and the first window displays a knee joint and
prosthesis three-dimensional image corresponding to the
flexion-extension angle.
28. A total knee arthroplasty robot auxiliary system, comprising:
an upper controller, a surgical controller, a femur tracer, a tibia
tracer, a bone-cutting guide tracer, a scanning probe and a guide
camera, wherein the upper controller provides a preoperative plan
and an intraoperative plan and transmits the intraoperative plan to
the surgical robot; the femur tracer and the tibia tracer are
respectively arranged at a femur and a tibia of a knee joint of a
patient, and the navigation camera cooperates with the femur tracer
and the tibia tracer to acquire motion track information of the
knee joint in the continuous lower limb flexion-extension process
during operation; the navigation camera cooperates with the
scanning probe to acquire surface contour data of the knee joint of
the patient; the navigation camera cooperates with the femur tracer
to acquire position information of the knee joint of the patient;
one end of the bone-cutting guide tracer is connected to a
bone-cutting guide for mounting a bone-cutting tool and the other
end of the bone-cutting guide tracer is connected to an operating
end of a mechanical arm of the surgical robot, and the navigation
camera cooperates with the bone-cutting guide tracer to acquire
position information of the bone-cutting guide; and the upper
controller is in communication connection to the robot, the femur
tracer, the tibia tracer, the bone-cutting guide tracer and the
navigation camera and is configured to generate the intraoperative
plan according to the acquired knee joint position information,
bone-cutting guide position information, knee joint surface contour
data and motion track information at the continuous
flexion-extension angle, and the robot receives the intraoperative
plan and controls the mechanical arm of the robot according to the
intraoperative plan, so that the bone-cutting guide is located in a
planned predetermined position.
29. The auxiliary system according to claim 28, comprising a
man-machine interaction device configured to display the dynamic
spacing force line data graph and display adjustment of the
prosthesis plan in response to user operation.
30. The robot auxiliary system according to claim 28, wherein the
bone-cutting guide comprises a plurality of through grooves,
wherein a predetermined angle is maintained between each through
groove and the adjacent through groove, and each through groove is
configured to accommodate the bone-cutting tool.
31. The auxiliary system according to claim 29, wherein the upper
controller is configured to: select one bone-cutting plane from a
plurality of bone-cutting planes determined according to the
intraoperative plan in response to operation of a user using the
man-machine interaction device in respective stages of the
arthroplasty, the plurality of bone-cutting planes comprising a
first bone-cutting plane, a second bone-cutting plane, a third
bone-cutting plane, a fourth bone-cutting plane, a fifth
bone-cutting plane and a sixth bone-cutting plane; and transmit the
intraoperative plan comprising the selected bone-cutting plane
information to the surgical robot; wherein the surgical robot
controls the mechanical arm to move according to the intraoperative
plan, so that at least one through groove of the bone-cutting guide
is aligned with the selected bone-cutting plane and the
bone-cutting guide is located at a corresponding planned
position.
32. The robot auxiliary system according to claim 30, wherein the
bone-cutting guide comprises a first through groove and a second
through groove intersected with the first through groove.
33. The auxiliary system according to claim 31, wherein the upper
controller is further configured to: update prosthesis plan data to
acquire a new intraoperative plan; select another bone-cutting
plane from the plurality of bone-cutting planes in response to
operation of a user using the man-machine interaction device;
transmit the intraoperative plan comprising the selected another
bone-cutting plane information to the surgical robot; wherein the
surgical robot controls the mechanical arm to move according to the
intraoperative plan, so that the through groove of the bone-cutting
guide is aligned with the selected another bone-cutting plane and
the bone-cutting guide is located at a corresponding planned
position.
34. The auxiliary system according to claim 31, wherein the first
bone-cutting plane, the second bone-cutting plane, the third
bone-cutting plane, the fourth bone-cutting plane, the fifth
bone-cutting plane and the sixth bone-cutting plane are
respectively one of a tibial distal-end bone-cutting plane, a
femoral distal-end bone-cutting plane, a femoral front-condyle
oblique bone-cutting plane, a femoral rear-condyle oblique
bone-cutting plane, a femoral front-condyle bone-cutting plane and
a femoral rear-condyle bone-cutting plane.
35. The auxiliary system according to claim 28, wherein the
bone-cutting guide tracer is an annular tracing device.
36. The auxiliary system according to claim 28, further comprising
a knee joint fixing device arranged on an operating table to fix
the knee joint of the patient.
37. The robot auxiliary system according to claim 29, wherein the
man-machine interaction device comprises a display screen
comprising a first window for displaying a knee joint
three-dimensional image and a second window for displaying knee
joint dynamic gap force line data, wherein the first window is
associated with the second window, so that when the first window
adjusts prosthesis position information, the second window displays
a knee joint dynamic gap force line graph at the position.
38. The robot auxiliary system according to claim 37, wherein the
prosthesis position information comprises at least one of an inner
and outer turning angle, an inner and outer rotating angle, a front
and back inclination angle, a vertical translation distance and a
transverse translation distance.
39. The auxiliary system according to claim 37, wherein a
flexion-extension angle is selected in the second window, the knee
joint dynamic gap force line graph at the current angle is
displayed, and the first window displays a knee joint and
prosthesis three-dimensional image corresponding to the
flexion-extension angle.
40. (canceled)
41. An electronic device, comprising: one or more processors; and a
storage device, for storing one or more programs, wherein when the
one or more programs are executed by the one or more processors,
the one or more processors are caused to implement the method
according to claim 1.
42. A computer readable medium, wherein a computer program is
stored in the computer readable medium; and the program, when
executed by the processor, enables the processor to implement the
method according to claim 1.
Description
TECHNICAL FIELD
[0001] The present invention relates to the technical field of
medical device, and in particular, relates to a total knee
arthroplasty (TKA) robot auxiliary system, a control method, an
electronic device and a computer readable medium.
BACKGROUND
[0002] In recent years, TKA, as an effective clinical operation for
treating severe knee pain, malformation and dysfunction, has been
widely carried out at home and abroad. The operation of the
artificial joint replacement is often subject to the experience and
estimation of surgeons, so it is difficult to ensure the matching
accuracy of the prosthesis and the femur and tibia of the
patient.
[0003] Compared with the traditional joint replacement, the
surgical robot may carry out individualized modeling, measurement
and design before operation to ensure accurate and safe operation
during the surgery, thus assisting in completing individualized and
precise artificial joint replacement and greatly reducing the
incidence rate of different leg lengths, joint dislocation,
prosthetic loosening and the like of patients after the operation
caused by precision problems.
[0004] Medical practice has found that there are still many
shortcomings in the surgical robot auxiliary system at present,
such as incomplete image registration, optical tracking and
positioning deviation, robot motion error and the like. These
factors lead to inaccurate operation of the robot auxiliary system
and cannot ensure reconstruction of good force line, thus resulting
in discomfort of the patients and affecting the life of the
prosthesis.
SUMMARY OF THE INVENTION
[0005] For the defects in the prior art, the present application
aims to provide a total knee arthroplasty robot auxiliary system
with higher accuracy, a control method, an electronic device and a
computer readable medium, so as to guide surgeons to perform
osteotomy more accurately.
[0006] The user characteristics and advantages of the present
application will become apparent from the following detailed
description, or will be partially learned through the practice of
the present application.
[0007] According to a first aspect of the present application, a
control method for a total knee arthroplasty robot auxiliary system
is provided, comprising:
[0008] generating a preoperative plan, wherein preoperative plan
data comprises an image of a patient knee joint;
[0009] generating an intraoperative plan, comprising: performing
image registration on the knee joint image in the preoperative plan
and a knee joint surface contour of the patient determined in an
operation; acquiring knee joint dynamic spacing force line data at
a continuous flexion-extension angle; visually displaying a dynamic
spacing force line data graph; and adjusting a prosthesis plan
according to the visual display of the dynamic spacing force line
data graph; and
[0010] controlling operation of a surgical robot according to the
adjusted prosthesis plan and guiding a bone-cutting guide to be
located at a planned predetermined position, wherein the
bone-cutting guide is mounted at an operating end of a mechanical
arm of the surgical robot to locate a bone-cutting saw.
[0011] According to some embodiments of the present application,
the acquiring knee joint dynamic spacing force line data at a
continuous flexion-extension angle comprises:
[0012] acquiring motion track information of the knee joint in the
continuous lower limb flexion-extension process; and
[0013] calculating a spacing and a force line angle at a continuous
lower limb flexion-extension angle according to the motion track
information.
[0014] According to some embodiments of the present application,
the adjusting a prosthesis plan comprises:
[0015] receiving prosthesis position adjusting information
interacted by a user; and
[0016] recalculating a spacing force line and refreshing the
dynamic spacing force line data graph.
[0017] According to some embodiments of the present application,
the prosthesis position information comprises at least one of a
varus/valgus angle, an external/internal rotation angle, a front
and back inclination angle, a vertical translation distance and a
transverse translation distance.
[0018] According to some embodiments of the present application,
the control method further comprises: visually adjusting the
preoperative plan before generating the intraoperative plan.
[0019] According to some embodiments of the present application,
the control method further comprises:
[0020] prior to controlling operation of the surgical robot
according to the adjusted prosthesis plan, simulating guiding the
mechanical arm in a man-machine interaction interface, so that the
bone-cutting guide arrives at the planned position and a through
groove of the bone-cutting guide is aligned with a corresponding
bone-cutting plane.
[0021] According to some embodiments of the present application,
the control method further comprises:
[0022] prior to controlling operation of the surgical robot
according to the adjusted prosthesis plan, selecting one
bone-cutting plane from a plurality of bone-cutting planes, wherein
the plurality of bone-cutting planes comprise a first bone-cutting
plane, a second bone-cutting plane, a third bone-cutting plane, a
fourth bone-cutting plane, a fifth bone-cutting plane and a sixth
bone-cutting plane; and
[0023] controlling the mechanical arm according to the prosthesis
plan, so that a through groove of the bone-cutting guide is aligned
with the selected bone-cutting plane and the bone-cutting guide is
located at a corresponding planned position.
[0024] According to some embodiments of the present application,
the control method further comprises:
[0025] updating prosthesis plan data;
[0026] selecting another bone-cutting plane from the plurality of
bone-cutting planes; and
[0027] guiding the mechanical arm according to the updated
prosthesis plan data, so that a through groove of the bone-cutting
guide is aligned with another selected bone-cutting plane and the
bone-cutting guide is located at a corresponding planned
position.
[0028] According to some embodiments of the present application,
the control method is characterized in that:
[0029] the first bone-cutting plane, the second bone-cutting plane,
the third bone-cutting plane, the fourth bone-cutting plane, the
fifth bone-cutting plane and the sixth bone-cutting plane are
respectively one of a tibial distal-end bone-cutting plane, a
femoral distal-end bone-cutting plane, a femoral front-condyle
oblique bone-cutting plane, a femoral rear-condyle oblique
bone-cutting plane, a femoral front-condyle bone-cutting plane and
a femoral rear-condyle bone-cutting plane.
[0030] According to a second aspect of the present application, a
total knee arthroplasty robot auxiliary system is provided,
comprising:
[0031] a preoperative planning system configured to formulate a
preoperative plan, wherein preoperative plan data comprises an
image of a patient knee joint;
[0032] an intraoperative planning system configured to formulate an
intraoperative plan, wherein the knee joint image in the
preoperative plan and a knee joint surface contour of the patient
determined in an operation are subjected to image registration,
knee joint dynamic spacing force line data at a continuous
flexion-extension angle is acquired, a dynamic spacing force line
data graph is visually displayed, and a prosthesis plan is adjusted
according to the visual display of the dynamic spacing force line
data graph to obtain the intraoperative plan; and
[0033] an executing system, wherein a bone-cutting guide mounted at
an operating end of a mechanical arm of a surgical robot is guided
to be located in a planned predetermined position according to the
intraoperative plan, and the bone-cutting guide is configured to
locate a bone-cutting saw.
[0034] According to some embodiments of the present application,
the preoperative planning system and the intraoperative planning
system are arranged in an upper controller, the executing system is
arranged in the surgical robot, and the upper controller transmits
the intraoperative plan to the surgical robot, so that the surgical
robot can execute corresponding operation according to the
plan.
[0035] According to some embodiments of the present application,
the intraoperative planning system comprises a positioning system,
the positioning system comprises a femur tracer, a tibia tracer and
a navigation camera, wherein the femur tracer and the tibia tracer
are respectively arranged at a femur and a tibia of a knee joint of
a patient, and the navigation camera cooperates with the femur
tracer and the tibia tracer to acquire and record motion track
information of the knee joint in the continuous lower limb
flexion-extension process; and
[0036] the upper controller is in communication connection to the
femur tracer, the tibia tracer and the navigation camera, and is
configured to acquire a spacing and a force line angle at a
continuous lower limb flexion-extension angle according to the
motion track information so as to acquire knee joint dynamic
spacing force line data at the continuous flexion-extension
angle.
[0037] According to some embodiments of the present application,
the positioning system further comprises a scanning probe with a
scanning tip arranged at one end thereof for scanning the knee
joint of the patient and a plurality of tracing components arranged
at the other end thereof, and the plurality of tracing components
are identified by the navigation camera to acquire a motion track
of the scanning tip; and
[0038] the upper controller is in communication connection to the
scanning probe and the navigation probe, and the upper controller
is configured to acquire knee joint surface contour data according
to the motion track of the scanning tip and perform image
registration on the knee joint image in the preoperative plan and
the patient knee joint surface contour acquired during
operation.
[0039] According to some embodiments of the present application,
the femur tracer cooperates with the navigation camera to acquire
and record position information of the knee joint; and
[0040] the upper controller is configured to formulate the
intraoperative plan according to position data of the knee
joint.
[0041] According to some embodiments of the present application,
the positioning system further comprises a bone-cutting guide
tracer mounted at an operating end of the mechanical arm, wherein
the bone-cutting guide is detachably mounted on the bone-cutting
guide tracer, and the navigation camera cooperates with the
bone-cutting guide tracer to acquire and record position
information of the bone-cutting guide; and
[0042] wherein the upper controller is in communication connection
to the bone-cutting guide tracer and the navigation camera, and is
configured to formulate the intraoperative plan according to
position data of the bone-cutting guide.
[0043] According to some embodiments of the present application,
the upper controller comprises a man-machine interaction device for
displaying the dynamic spacing force line data graph and displaying
adjustment of the prosthesis plan in response to user
operation.
[0044] According to some embodiments of the present application,
the bone-cutting guide comprises a first through groove and a
second through groove intersected with the first through groove,
and the through grooves are configured to accommodate the
bone-cutting saw.
[0045] According to some embodiments of the present application,
the upper controller is configured to:
[0046] select one bone-cutting plane from a plurality of
bone-cutting planes respectively in response to operation of a user
using the man-machine interaction device in respective stages of
the arthroplasty, the plurality of bone-cutting planes comprising a
first bone-cutting plane, a second bone-cutting plane, a third
bone-cutting plane, a fourth bone-cutting plane, a fifth
bone-cutting plane and a sixth bone-cutting plane; and
[0047] transmit the intraoperative plan comprising the selected
bone-cutting plane information to the surgical robot; and
[0048] wherein the surgical robot controls the mechanical arm to
move according to the intraoperative plan, so that the through
groove of the bone-cutting guide is aligned with the selected
bone-cutting plane and the bone-cutting guide is located at a
corresponding planned position.
[0049] According to some embodiments of the present application,
the upper controller is further configured to:
[0050] update prosthesis plan data to acquire a new intraoperative
plan;
[0051] select another bone-cutting plane from the plurality of
bone-cutting planes in response to operation of a user using the
man-machine interaction device;
[0052] transmit the intraoperative plan comprising the selected
another bone-cutting plane information to the surgical robot;
[0053] wherein the surgical robot controls the mechanical arm to
move according to the intraoperative plan, so that the through
groove of the bone-cutting guide is aligned with the selected
another bone-cutting plane and the bone-cutting guide is located at
a corresponding planned position.
[0054] According to some embodiments of the present application,
the first bone-cutting plane, the second bone-cutting plane, the
third bone-cutting plane, the fourth bone-cutting plane, the fifth
bone-cutting plane and the sixth bone-cutting plane are
respectively one of a tibial distal-end bone-cutting plane, a
femoral distal-end bone-cutting plane, a femoral front-condyle
oblique bone-cutting plane, a femoral rear-condyle oblique
bone-cutting plane, a femoral front-condyle bone-cutting plane and
a femoral rear-condyle bone-cutting plane.
[0055] According to some embodiments of the present application, a
tracer is mounted on the bone-cutting saw.
[0056] According to some embodiments of the present application, a
strain gauge is mounted at a free end of the bone-cutting saw.
[0057] According to some embodiments of the present application,
the bone-cutting guide tracer is an annular tracing device.
[0058] According to some embodiments of the present application,
the total knee arthroplasty robot auxiliary system further
comprises a knee joint fixing device arranged on an operating table
for fixing the knee joint of the patient.
[0059] According to some embodiments of the present application,
the man-machine interaction device comprises a display screen
comprising a first window for displaying a knee joint
three-dimensional image and a second window for displaying knee
joint dynamic gap force line data, wherein the first window is
associated with the second window so that when the first window
adjusts prosthesis position information, the second window displays
a knee joint dynamic gap force line graph at the position.
[0060] According to some embodiments of the present application,
the prosthesis position information comprises at least one of a
varus/valgus angle, an external/internal rotation angle, a front
and back inclination angle, a vertical translation distance and a
transverse translation distance.
[0061] According to some embodiments of the present application, a
flexion-extension angle is selected in the second window, the knee
joint dynamic gap force line graph at the current angle is
displayed, and the first window displays a knee joint and
prosthesis three-dimensional image corresponding to the
flexion-extension angle.
[0062] According to a third aspect of the present application, a
total knee arthroplasty robot auxiliary system is provided,
comprising: an upper controller, a surgical controller, a femur
tracer, a tibia tracer, a bone-cutting guide tracer, a scanning
probe and a guide camera, wherein
[0063] the upper controller provides a preoperative plan and an
intraoperative plan and transmits the intraoperative plan to the
surgical robot;
[0064] the femur tracer and the tibia tracer are respectively
arranged at a femur and a tibia of a knee joint of a patient, and
the navigation camera cooperates with the femur tracer and the
tibia tracer to acquire motion track information of the knee joint
in the continuous lower limb flexion-extension process during
operation;
[0065] the navigation camera cooperates with the scanning probe to
acquire surface contour data of the knee joint of the patient;
[0066] the navigation camera cooperates with the femur tracer to
acquire position information of the knee joint of the patient;
[0067] one end of the bone-cutting guide tracer is connected to a
bone-cutting guide for mounting a bone-cutting tool and the other
end of the bone-cutting guide tracer is connected to an operating
end of a mechanical arm of the surgical robot, and the navigation
camera cooperates with the bone-cutting guide tracer to acquire
position information of the bone-cutting guide; and
[0068] the upper controller is in communication connection to the
robot, the femur tracer, the tibia tracer, the bone-cutting guide
tracer and the navigation camera and is configured to generate the
intraoperative plan according to the acquired knee joint position
information, bone-cutting guide position information, knee joint
surface contour data and motion track information at the continuous
flexion-extension angle, and
[0069] the robot receives the intraoperative plan and controls the
mechanical arm of the robot according to the intraoperative plan,
so that the bone-cutting guide is located in a planned
predetermined position.
[0070] According to some embodiments of the present application,
the auxiliary system comprises a man-machine interaction device in
communication connection to the upper controller and configured to
display the dynamic spacing force line data graph and display
adjustment of the prosthesis plan in response to user
operation.
[0071] According to some embodiments of the present application,
the bone-cutting guide comprises a plurality of through grooves,
wherein a predetermined angle is maintained between each through
groove and the adjacent through groove, and each through groove is
configured to accommodate the bone-cutting tool.
[0072] According to some embodiments of the present application,
the upper controller is configured to:
[0073] select one bone-cutting plane from a plurality of
bone-cutting planes which are determined according to the
intraoperative plan in response to operation of a user using the
man-machine interaction device in respective stages of the
arthroplasty, the plurality of bone-cutting planes comprising a
first bone-cutting plane, a second bone-cutting plane, a third
bone-cutting plane, a fourth bone-cutting plane, a fifth
bone-cutting plane and a sixth bone-cutting plane; and
[0074] transmit the intraoperative plan comprising the selected
bone-cutting plane information to the surgical robot;
[0075] wherein the surgical robot controls the mechanical arm to
move according to the intraoperative plan, so that at least one
through groove of the bone-cutting guide is aligned with the
selected bone-cutting plane and the bone-cutting guide is located
at a corresponding planned position.
[0076] According to some embodiments of the present application,
the bone-cutting guide comprises a first through groove and a
second through groove intersected with the first through
groove.
[0077] According to some embodiments of the present application,
the upper controller is further configured to:
[0078] update prosthesis plan data to acquire a new intraoperative
plan;
[0079] select another bone-cutting plane from the plurality of
bone-cutting planes in response to operation of a user using the
man-machine interaction device;
[0080] transmit the intraoperative plan comprising the selected
another bone-cutting plane information to the surgical robot;
[0081] wherein the surgical robot controls the mechanical arm to
move according to the intraoperative plan, so that the through
groove of the bone-cutting guide is aligned with the selected
another bone-cutting plane and the bone-cutting guide is located at
a corresponding planned position.
[0082] According to some embodiments of the present application,
the first bone-cutting plane, the second bone-cutting plane, the
third bone-cutting plane, the fourth bone-cutting plane, the fifth
bone-cutting plane and the sixth bone-cutting plane are
respectively one of a tibial distal-end bone-cutting plane, a
femoral distal-end bone-cutting plane, a femoral front-condyle
oblique bone-cutting plane, a femoral rear-condyle oblique
bone-cutting plane, a femoral front-condyle bone-cutting plane and
a femoral rear-condyle bone-cutting plane.
[0083] According to some embodiments of the present application,
the bone-cutting guide tracer is an annular tracing device.
[0084] According to some embodiments of the present application,
the total knee arthroplasty robot auxiliary system further
comprises a knee joint fixing device arranged on an operating table
for fixing the knee joint of the patient.
[0085] According to some embodiments of the present application,
the man-machine interaction device comprises a display screen
comprising a first window for displaying a knee joint
three-dimensional image and a second window for displaying knee
joint dynamic gap force line data, wherein the first window is
associated with the second window, so that when the first window
adjusts prosthesis position information, the second window displays
a knee joint dynamic gap force line graph at the position.
[0086] According to some embodiments of the present application,
the prosthesis position information comprises at least one of a
varus/valgus angle, an external/internal rotation angle, a front
and back inclination angle, a vertical translation distance and a
transverse translation distance.
[0087] According to some embodiments of the present application, a
flexion-extension angle is selected in the second window, the knee
joint dynamic gap force line graph at the current angle is
displayed, and the first window displays a knee joint and
prosthesis three-dimensional image corresponding to the
flexion-extension angle.
[0088] According to a fourth aspect of the present application, a
control device for performing total knee arthroplasty by a surgical
robot auxiliary system is provided, comprising:
[0089] a preoperative plan acquisition module configured to acquire
a preoperative plan;
[0090] an intraoperative plan acquisition module configured to
acquire an intraoperative plan and comprising:
[0091] an image registration module configured to perform image
registration on a knee joint image in preoperative plan data and an
intraoperative knee joint surface contour;
[0092] a visual display module configured to display the knee joint
image after registration and the dynamic gap force line data
graph;
[0093] an adjusting module configured to adjust a prosthesis plan
according to the visual display of the dynamic spacing force line
data; and
[0094] an operation control module configured to control operation
of the surgical robot according to the adjusted prosthesis plan and
guide a bone-cutting guide to be located at a planned predetermined
position, wherein the bone-cutting guide is mounted at an operating
end of a mechanical arm of the surgical robot to locate a
bone-cutting saw.
[0095] According to a fifth aspect of the present application, an
electronic device is provided, comprising:
[0096] one or more processors; and
[0097] a storage device for storing one or more programs,
[0098] wherein when the one or more programs are executed by the
one or more processors, the one or more processors are caused to
implement the method described above.
[0099] According to a sixth aspect of the present application, a
computer readable medium is provided, wherein a computer program is
stored in the computer readable medium; and the program, when
executed by the processor, enables the processor to implement the
method described above.
[0100] The total knee arthroplasty robot auxiliary system and
control method thereof according to the present application allow
the surgeon to adjust the position of the joint prosthesis and the
bone-cutting plan at a flexion-extension angle where the lower limb
of the patient can reach, thus effectively improving reconstruction
of the force line and the postoperative soft tissue balance.
Furthermore, the total knee arthroplasty robot auxiliary system
according to the present application has higher accuracy;
therefore, by virtue of the surgical robot auxiliary system
provided by the present application, accurate positioning and
bone-cutting operation of six bone-cutting planes on the tibia and
the femur of the corresponding prosthesis can be realized, and
secondary injury by a pin nailed into the femur caused by the fact
that the traditional auxiliary system adopts a four-in-one cutting
guide device to perform bone cutting can be avoided.
[0101] It should be understood that the above general description
and the following detailed description are exemplary only and not
intended to limit the present application.
BRIEF DESCRIPTION OF DRAWINGS
[0102] The above and other descriptions, features and advantages of
the present application will become more apparent from the
following detailed description of the exemplary embodiments with
reference to the accompanying drawings.
[0103] FIG. 1A is a schematic framework graph of a total knee
arthroplasty robot auxiliary system according to an exemplary
embodiment of the present application;
[0104] FIG. 1B is a schematic graph of a formulating process of an
intraoperative plan according to an exemplary embodiment of the
present application;
[0105] FIG. 2 is a composition schematic graph of a total knee
arthroplasty robot auxiliary system according to an exemplary
embodiment of the present application;
[0106] FIG. 3 is a schematic graph I of a man-machine interaction
interface according to an exemplary embodiment of the present
application;
[0107] FIG. 4 is a graph of a dynamic spacing force line according
to an exemplary embodiment of the present application;
[0108] FIG. 5 is a schematic graph II of a man-machine interaction
interface according to an exemplary embodiment of the present
application;
[0109] FIG. 6 is a schematic graph of a scanning probe according to
an exemplary embodiment of the present application;
[0110] FIG. 7 is a schematic graph of a bone-cutting guide
according to an exemplary embodiment of the present
application;
[0111] FIG. 8 is a schematic graph of a bone-cutting guide tracer
according to an exemplary embodiment of the present
application;
[0112] FIG. 9A is a schematic graph of a knee joint fixator
according to an exemplary embodiment of the present
application;
[0113] FIG. 9B is a schematic graph of a clamp assembly for the
knee joint fixator in FIG. 9A;
[0114] FIG. 10 is a schematic graph of a prosthesis according to an
exemplary embodiment of the present application;
[0115] FIG. 11 is a control flowchart of a total knee arthroplasty
robot auxiliary system according to an exemplary embodiment of the
present application;
[0116] FIG. 12 is a control device for a total knee arthroplasty
robot auxiliary system according to an exemplary embodiment of the
present application; and
[0117] FIG. 13 is a block graph of an electronic device according
to an exemplary embodiment of the present application.
DETAILED DESCRIPTION
[0118] Exemplary embodiments are described in more details
hereinafter with reference to the accompanying drawings. However,
the exemplary embodiments can be implemented in various forms and
should not be construed as being limited to the embodiments
described herein; on the contrary, these embodiments are provided,
so that the present application will be comprehensive and complete,
and the concept of the exemplary embodiments will be fully conveyed
to those skilled in the art. In the drawings, the same reference
sign denotes the same or similar parts, and thus their repeated
description will be omitted.
[0119] The features, structures, materials or characteristics
described may be combined in any one or more embodiments in any
suitable manner. In the following description, numerous specific
details are provided to give a sufficient understanding of the
embodiments of the present disclosure. However, those skilled in
the art will realize that the technical solutions of the present
disclosure may be practiced without one or more of these specific
details, or other methods, components, materials, devices or the
like may be adopted. In these cases, the commonly known structures,
methods, devices, implementation, materials or operation will not
be shown or described in details.
[0120] The block graph shown in the drawings does not necessarily
correspond to a physically independent entity. These functional
entities or part of these functional entities may be implemented by
software or in one or more hardware modules and/or programmable
modules, or these functional entities may be implemented in
different networks and/or processor devices and/or micro-control
devices.
[0121] The flowchart shown in the drawings is exemplarily described
only, does not necessarily include all contents and
operations/steps and is not necessarily implemented in the
described order. For example, some operations/steps may be
decomposed, while some operations/steps may be combined or
partially combined; therefore, the actually implemented order may
change according to the actual situation.
[0122] The terms "first", "second", and so on in the description
and claims of the present application and in the above accompanying
drawings are used only for distinguishing different objects, but
not for describing a specific order. In addition, the terms
"include", "have" and any variants thereof are intended to cover
non-exclusive inclusion. For example, processes, methods, systems,
products or device including a series of steps or units are not
limited to the listed steps or units, but optionally include steps
or units which are not listed, or optionally include other steps or
units inherent to these processes, methods, products or device.
[0123] The technical concept of the present application is
elaborated with reference to FIG. 1A. FIG. 1A is a schematic
framework graph of a total knee arthroplasty robot auxiliary system
according to an exemplary embodiment of the present
application.
[0124] As shown in FIG. 1A, the present invention provides a total
knee arthroplasty robot auxiliary system with higher precision,
comprising: a preoperative planning system 10, an intraoperative
planning system 20 and an executing system 30.
[0125] The preoperative planning system 10 formulates a
preoperative plan which may be completed in a preoperative end work
station. Firstly, a user (engineer) inputs a computed tomography
(CT) or a magnetic resonance imaging (MM) image data set of a
patient acquired from a hospital into the preoperative end work
station to generate a three-dimensional (3D) model of a bone
anatomical structure of the patient; and prosthesis data (3-D
computer aided design model) provided by a prosthesis manufacturer
is loaded to the preoperative end workstation. In this way, the
user may try to place the prosthesis in the 3D model of the bone
anatomical structure to preliminarily select the prosthesis,
specify the optimal cooperation position and direction the
prosthesis and bone, and formulate a preliminary preoperative
plan.
[0126] The preoperative plan is based on the 3D reconstruction
model of the patient, has a certain error and only can reflect the
static information of the bone. Therefore, it is necessary to
adjust the preoperative plan according to the actual bone
conditions of the patient, including the bone dynamic state, that
is, to formulate the intraoperative plan. The intraoperative plan
is performed by the intraoperative planning system 20 and may be
completed by the intraoperative end work station placed in the
operating room. During the operation, the preoperative plan is
adjusted according to the lower limb force line and dynamic lower
limb position information of the patient, so that better surgical
effect is achieved.
[0127] The existing intraoperative plan adjusting method can
provide the surgeon with lower limb force line information and
spacing information at surgeona lower limb flexion-extension angle
of 0 degree and 90 degrees. The surgeon may adjust the prosthesis
planning position and optimize the bone-cutting scheme in the
operation according to the above information. However, the
flexion-extension angle range which the knee joint may reach is -10
degrees to 130 degrees. Obviously, the plan position and the
bone-cutting scheme which are acquired by adjusting the
intraoperative plan only according to the information at the
flexion-extension angles of 0 degree and 90 degrees are not
accurate. This will lead to that the final placement of the
prosthesis cannot make the patient have comfortable feeling in
squatting, sitting, going up and down stairs and other postures
like normal people.
[0128] The present application allows the surgeon to adjust the
position of the joint prosthesis and the bone-cutting scheme by
up-and-down and left-and-right translation, clockwise and
anticlockwise rotation, etc., of the joint prosthesis within the
flexion-extension angle range which the patient lower limb can
reach. Moreover, an intuitive and flexible plan basis is provided
for the surgeon by the dynamic gap force line data graph, thereby
effectively improving reconstruction of the force line and the
postoperative soft tissue balance.
[0129] Now, the solution of the exemplary embodiment of the present
application is integrally introduced with reference to FIG. 1A,
FIG. 1B, FIG. 3, FIG. 4 and FIG. 6. FIG. 1B is a schematic graph of
a formulating process of an intraoperative plan according to an
exemplary embodiment of the present application, FIG. 3 is a
schematic graph I of a man-machine interaction interface according
to an exemplary embodiment of the present application; FIG. 4 is a
graph of a dynamic spacing force line according to an exemplary
embodiment of the present application; and FIG. 6 is a schematic
graph of a scanning probe according to an exemplary embodiment of
the present application.
[0130] Referring to FIG. 1A, as described above, the total knee
arthroplasty robot auxiliary system comprises a preoperative
planning system 10, an intraoperative planning system 20 and an
executing system 30.
[0131] Preoperative Planning System
[0132] The preoperative planning system 10 formulates a
preoperative plan. The preoperative plan may be implemented in a
preoperative end workstation. Firstly, a user (engineer) loads
prosthesis data (3-D computer aided design model) provided by a
prosthesis manufacturer to the preoperative end work station and
inputs a CT or an MRI image data set of a patient acquired from a
hospital into the preoperative end work station. Then, according to
the acquired CT or Mill image, a bone surface of a region of
interest (ROI) of a femur and a tibia is extracted, and the femur
and the tibia are separated to form two independent 3D models. A
registration point and a check point (may be bone mark points) for
subsequent image registration are pre-generated on the 3D model.
The required joint prosthesis model is placed in the 3D model of
the bone anatomical structure. The coordinate systems of the femur
and the tibia are determined, and the three-dimensional images of
the femur and the tibia are corrected based on the coordinate
systems. The position and direction of the joint prosthesis are
adjusted, so that preoperative optimized cooperation of the joint
prosthesis and the bone is realized and the preoperative plan is
obtained based on this.
[0133] Data acquired by the preoperative plan comprises: prosthesis
data such as joint prosthesis model number and the like, and a
preliminary bone-cutting scheme, etc. The prosthesis data further
comprises three-dimensional model data of the joint prosthesis and
a spatial definition of the joint prosthesis corresponding to human
anatomy. The preliminary bone-cutting scheme comprises a spatial
position and a bone-cutting plane thereof, etc., wherein the
spatial position is generated through three-dimensional planning of
the joint prosthesis and the bone model of the patient and is
matched with the planned joint prosthesis.
[0134] Intraoperative Planning System
[0135] The intraoperative planning system 20 formulates an
intraoperative plan. As shown in FIG. 1B, the intraoperative plan
is implemented by an intraoperative end work station in an
operating room. According to one exemplary embodiment of the
present application, the intraoperative end work station may be
integrated with the preoperative end work station, as shown in FIG.
2, the upper controller completes the work of the intraoperative
end work station and the preoperative end work station at the same
time.
[0136] FIG. 1B is a schematic graph of a formulating process of an
intraoperative plan. Firstly, in S100 shown in FIG. 1B, the
corrected knee joint image in the preoperative plan and the knee
joint image of the patient are subjected to image registration.
Specifically, the preoperative plan image and the knee joint
surface contour of the patient are subjected to image registration.
Image registration is described below with reference to FIG. 6. In
the operation, the surgeon performs point contact on some
positions, such as bone mark points, of the knee joint by a tip
1401 of a scanning probe 1400 shown in FIG. 6. Optical tracking
device, such as a navigation camera 1093 in FIG. 2, tracks a
tracking component 1402 at one end of the scanning probe 1400 so as
to show the point contact position. If the registration result is
accurate, a corresponding point will be displayed on the image; and
if the registration result is not accurate, it is necessary to
perform registration again until the result meets the corresponding
requirement. According to one exemplary embodiment of the present
application, accurate registration of the femoral and tibial joint
surfaces is respectively realized by a point cloud registration
algorithm. For example, six mark points may be roughly registered
firstly, then multiple points are accurately registered, and
finally the registration results are verified.
[0137] After image registration, in S200 shown in FIG. 1B, knee
joint dynamic spacing force line data at a continuous
flexion-extension angle is acquired. According to the exemplary
embodiment of the present application, the acquiring knee joint
dynamic spacing force line data at a continuous flexion-extension
angle comprises: acquiring motion track information of the knee
joint in the continuous lower limb flexion-extension process; and
calculating a spacing and a force line angle at a continuous lower
limb flexion-extension angle according to the motion track
information. Specifically, for example, tracers are arranged at the
femur and the tibia of the knee joint; and in the continuous
flexion-extension process of the lower limb, the tracers are
continuously tracked by the navigation camera, and the motion track
information of the knee joint is acquired and recorded. The spacing
comprises a first spacing and a second spacing. The first spacing
is the minimum spacing between an outer surface of a medial femoral
condyle of the prosthesis and a bone-cutting plane of the tibia,
and the second spacing is the minimum spacing between an outer
surface of a lateral femoral condyle and the bone-cutting plane of
the tibia. The force line angle is an included angle between a
mechanical axis of the femur and a mechanical axis of the
tibia.
[0138] Then, in S300 shown in FIG. 1B, the dynamic spacing force
line data graph is displayed; and according to the graph, in S400
shown in FIG. 1B, the prosthesis plan is visually adjusted to
obtain the intraoperative plan. The dynamic spacing force line data
graph is shown in FIG. 4 and comprises a first spacing curve 610, a
second spacing curve 620 and a force line angle change curve 630.
The first spacing curve 610 is drawn by taking the
flexion-extension angle of the lower limb as a y-coordinate and the
first spacing as an x-coordinate. The second spacing curve 620 is
drawn by taking the flexion-extension angle of the lower limb as a
y-coordinate and the second spacing as an x-coordinate. The force
line angle change curve 630 is drawn by taking the
flexion-extension angle of the lower limb as a y-coordinate and the
force line angle as an x-coordinate. FIG. 3 shows a schematic graph
I of a man-machine interaction interface according to an exemplary
embodiment. The interface provides interactively editable
prosthesis position information and comprises a varus/valgus angle,
an external/internal rotation angle, a front and back inclination
angle, a vertical translation distance, a transverse translation
distance and the like. The surgeon may interactively adjust the
prosthesis position at a window on the left side of the interface
through the visual display interface. According to the received
prosthesis position adjusting information, the spacing force line
is recalculated, and the dynamic spacing force line data graph is
refreshed at a window on the right side of the interface.
[0139] An intuitive and clear plan adjusting result is provided for
the surgeon through the prosthesis position adjusting information
and the visual display of the dynamic gap force line. The surgeon
may continuously adjust the prosthesis position information
according to the visual display of the dynamic spacing force line
data graph until information displayed by the dynamic spacing force
line data graph meets the requirements of the surgeon.
[0140] The first spacing and the second spacing may be obtained as
follows: firstly, the lowest point of a curved surface of the outer
surface of the prosthesis femur on a neutral vertical axis of the
human body is calculated, wherein the outer surface of the medial
femoral condyle of the prosthesis is adopted when calculating the
first spacing; and the outer surface of the lateral femoral condyle
of the prosthesis is adopted when calculating the second spacing.
Then, a distance from the lowest point to the bone-cutting plane of
the tibia is calculated. The calculated distance is a distance from
a three-dimensional space curved surface to a three-dimensional
space plane, which can more truly reflect the motion state of the
knee joint.
[0141] The force line angle may be calculated by the following
method: the mechanical axis of the femur and the mechanical axis of
the tibia are projected on a neutral coronal plane of the human
body respectively to obtain a projection axis of the femur and a
projection axis of the tibia, and then an included angle between
the projection axis of the femur and the projection axis of the
tibia is calculated.
[0142] According to some embodiments, a lower limb force line is
obtained by a certain algorithm before dynamic spacing force line
data is acquired. Specifically, it is necessary to consider the
requirement on a center of a femoral head and mark bone marker
points to determine a center of a femoral condyle, a center of a
tibial platform and a center of an ankle mortise. The center of the
femoral head and the center of the femoral condyle determine a line
segment, and the center of the tibial platform and the center of
the ankle mortise determine a line segment, so that a true lower
limb force line is obtained. An included angle formed by
projections of the two line segments on the coronal plane is a
force line included angle.
[0143] Data acquired by the intraoperative plan comprises:
prosthesis data such as joint prosthesis model number and the like,
and the final bone-cutting scheme, etc. The prosthesis data
comprises three-dimensional model data of the joint prosthesis and
a spatial definition of the joint prosthesis corresponding to human
anatomy. The final bone-cutting scheme comprises a spatial position
and a bone-cutting plane thereof, etc., wherein the spatial
position is generated through three-dimensional planning of the
joint prosthesis and the bone model of the patient and is matched
with the planned joint prosthesis.
[0144] Executing System
[0145] The executing system 30 may be implemented by a surgical
robot, wherein replacement operation is performed according to the
adjusted prosthesis plan, a bone-cutting guide mounted at an
operating end of a mechanical arm of the surgical robot is guided
to be located in a planned predetermined position, and the
bone-cutting guide is configured to locate a bone-cutting saw.
[0146] The surgical robot auxiliary system is integrally introduced
above and then is described from the implementation level with the
help of FIG. 2. FIG. 2 shows a composition schematic graph of a
total knee arthroplasty robot auxiliary system with higher
precision according to an exemplary embodiment of the present
application. As shown in FIG. 2, the total knee arthroplasty robot
auxiliary system may comprise an upper controller 101, a
man-machine interaction device 103, a surgical robot 105, a
scanning probe 1400, a bone-cutting guide 107, a knee joint tracer
109, a bone-cutting guide tracer 1111 and a navigation camera
1093.
[0147] The upper controller 101 may complete tasks of the
preoperative end work station and the intraoperative end work
station in FIG. 1B, namely including the preoperative planning
system 10 and the intraoperative planning system 20 in FIG. 1, and
can formulate a preoperative plan and an intraoperative plan
respectively and transmit the intraoperative plan to the executing
system 30, namely, surgical robot 105 to perform correct
bone-cutting operation.
[0148] Specifically, the upper controller 101 is in communication
connection to the man-machine interaction device 103, the surgical
robot 105 and the navigation camera 1093 respectively, receives
information transmitted by the man-machine interaction device 103
and the navigation camera 1093, and transmits related information
or instructions to the man-machine interaction device 103, the
surgical robot 105 and the navigation camera 1093.
[0149] In some embodiments, the upper controller 101 may also be in
communication connection to the scanning probe 1400, the
bone-cutting guide 107, the knee joint tracer 109, the bone-cutting
guide tracer 1111 and the like, for example, to control actuation
of these components, etc.
[0150] The knee joint tracer 109, the bone-cutting guide tracer
1111, the scanning probe 1400 and the navigation camera 1093 form a
positioning assembly.
[0151] One end of the bone-cutting guide tracer 1111 is mounted at
an operating end of a mechanical arm 1051 of the surgical robot
105, and the bone-cutting guide 107 may be detachably mounted at
the other end of the bone-cutting guide tracer 1111. A bone-cutting
saw is mounted on the bone-cutting guide 107 for performing
bone-cutting operation on the femur and the tibia. The bone-cutting
guide tracer 1111 may be provided with a tracing component such as
an infrared emitter or a reflective ball, etc. The navigation
camera 1093 comprises an optional sensor which may receive a signal
transmitted by the tracing component of the bone-cutting guide
tracer 1111. The navigation camera 1093 transmits the above
information to the upper controller 101, the upper controller 101
determines position information of the bone-cutting guide 107, and
the position information serves as a basis for planning a surgical
path of the mechanical arm and is configured to form the
intraoperative plan.
[0152] The knee joint tracer 109 comprises a femur tracer 1091 and
a tibia tracer 1092 arranged on the femur and the tibia
respectively. Both the femur tracer 1091 and the tibia tracer 1092
may show the position of the knee joint. The position information
of the knee joint is generally acquired through cooperation of the
femur tracer 1091 and the navigation camera 1093. The navigation
camera 1093 transmits the above information to the upper controller
101, the upper controller 101 determines the position of the knee
joint, and the position information serves as a basis for planning
a surgical path of the mechanical arm and is configured to form the
intraoperative plan.
[0153] In addition, the femur tracer 1091 and the tibia tracer 1092
further may cooperate with the navigation camera 1093 to acquire
and record the motion track information of the knee joint in the
continuous flexion-extension process of the lower limb. The
navigation camera 1093 transmits the above information to the upper
controller 101, and the upper controller 101 calculates a spacing
and a force line angle at the continuous flexion-extension angle of
the lower limb according to the motion track information and the
above method so as to acquire a knee joint dynamic spacing force
line at the continuous flexion-extension angle. The dynamic spacing
force line information, serving as an important basis for adjusting
the plan, is configure to form the intraoperative plan.
[0154] The scanning probe 1400 cooperates with the navigation
camera 1093 to acquire knee joint surface contour data of the
patient. Specifically, as shown in FIG. 6, a scanning tip 1401 is
arranged at one end of the scanning probe 1400 for scanning the
knee joint of the patient, and a plurality of tracing components
1402 which can be identified by the navigation camera 1093 are
arranged at the other end of the scanning probe 1400. Similarly,
the navigation camera 1093 transmits the above information to the
upper controller 101 to obtain the motion track of the scanning tip
1401 and acquire the knee joint surface contour data; and the data
is applied to the intraoperative image registration to form the
intraoperative plan.
[0155] The formed intraoperative plan comprises a final
bone-cutting scheme. The final bone-cutting scheme further
comprises a spatial position, a bone-cutting plane and the finally
formed surgical path of the bone-cutting guide, etc., wherein the
spatial position is generated through three-dimensional planning of
the joint prosthesis and the bone model of the patient and is
matched with the planned joint prosthesis. The surgical path of the
bone-cutting saw is determined according to bone-cutting plane
data, knee joint position information acquired by the knee joint
tracer 109 and guide position information acquired by the
bone-cutting guide tracer 1111.
[0156] The man-machine interaction device 103, for example in an
embodiment, comprises two or more display screens. One display
screen 1031, together with the upper controller 101, forms an upper
computer for providing man-machine interaction at a preoperative
planning stage; and the other display screen 1032 provides visual
adjustment for prosthesis planning to the surgeon in the operation
process. The two display screens may be of the same or different
type. The display screen 1032 is generally a touch screen to
facilitate the operation of the surgeon during operation.
[0157] Adjustment of prosthesis planning by the man-machine
interaction device 103 is described below with reference to FIG. 3
to FIG. 5.
[0158] FIG. 3 shows a man-machine interaction interface I of a
total knee arthroplasty robot auxiliary system according to an
exemplary embodiment of the present application.
[0159] As shown in FIG. 3, the interaction interface comprises a
left window and a right window. The left window displays three knee
joint views, respectively representing the state of knee joint and
prosthesis when the flexion-extension angles are 0.degree.,
45.degree. and 90.degree.. In addition, the left window also
provides editable prosthesis data parameters for the surgeon to
adjust the plan. The editable prosthesis data parameters
specifically comprise:
[0160] Varus/valgus angle: the varus/valgus angle (Varus/Valgus)
between the femur/tibia prosthesis and bone. When the prosthesis is
varus relative to the bone, the degree of the Varus angle is
displayed. If the angle is 0.degree., it is displayed as
Varus/Valgus 0.degree.. When the prosthesis is valgus relative to
the bone, the degree of the Valgus angle is displayed.
[0161] Internal/external rotation angle: the internal/external
rotation angle (External/Internal) of the femur/tibia prosthesis
relative to the bone. When the prosthesis is externally rotated
relative to the bone, the degree of external rotation (External) is
displayed. If the degree of external rotation is 0.degree., it is
displayed as External/Internal 0.degree.. When the prosthesis is
internally rotated relative to the bone, the degree of internal
rotation (Internal) is displayed.
[0162] Planned Varus/Valgus: The planned force line angle of the
lower limb at the currently selected flexion-extension angle.
[0163] The right window displays the dynamic spacing force line
data graph which will be described in detail with reference to FIG.
4.
[0164] As shown in FIG. 4, the visual dynamic spacing force line
data graph 600 according to the present application comprises a
first spacing curve 610, a second spacing curve 620 and a force
line angle change curve 630. The y-coordinates of the first spacing
curve 610, the second spacing curve 620 and the force line angle
change curve 630 represent the flexion-extension angles of the
lower limb. The flexion-extension angle of the human knee joint is
from -10.degree. to 130.degree..
[0165] Referring to FIG. 4, the first spacing curve 610 takes the
first spacing as a first x-coordinate, and the second spacing curve
620 takes the second spacing as a second x-coordinate. The first
x-coordinate and the second x-coordinate share an original point to
form a spacing x-coordinate. The spacing x-coordinate may be
arranged below the dynamic spacing force line data graph and
extends towards left and right sides. The first spacing curve and
the second spacing curve are arranged on two sides of the spacing
x-coordinate original point respectively.
[0166] As shown in FIG. 4, the force line angle change curve 630
takes a force line angle as an x-coordinate. The force line angle
x-coordinate may be arranged above the dynamic spacing force line
data graph. The original point is located at a middle position. One
side of the original point is positive and the other side of the
original point is negative. The force line angle is controlled
between -3.degree. and 3.degree., and the soft tissue may be
balanced well after the operation.
[0167] FIG. 5 shows a schematic graph II of a man-machine
interaction interface according to an exemplary embodiment of the
present application. The surgical robot auxiliary system according
to the exemplary embodiment of the present application not only
provides visual data display for the surgeon, but also provides
interactive plan adjustment for the surgeon.
[0168] When the surgeon adjusts prosthesis parameter information at
the left window in FIG. 5, for example, the varus/valgus angle, the
internal/external rotation angle and the like, the interaction
interface recalculates the first spacing, the second spacing and
the force line angle by the calculation method described above
after receiving the adjusted prosthesis parameter information and
then displays the adjusted dynamic spacing force line data graph on
the right window of the interaction interface in real time. As
shown in FIG. 5, it is an interaction interface after the
prosthesis parameter is adjusted.
[0169] The left window and the right window in the interaction
interface are associated with each other. As shown in FIG. 5, when
the prosthesis position information is adjusted in the left window,
the right window displays the knee joint dynamic gap force line
graph at the position. Meanwhile, different flexion-extension
angles of the lower limb may be selected in the right window, the
left window correspondingly displays three knee joint views at the
angle, and the surgeon may determine whether prosthesis position is
proper and the force line is ideal according to these knee joint
views and the current spacing force line graph and may further
adjust the prosthesis position at the angle in the left window.
[0170] It can be seen that according to the embodiment of the
present application, the surgeon may adjust the prosthesis plan at
any one flexion-extension angle in the reachable flexion-extension
angle range of the lower limb; therefore, the prosthesis plan close
to the real activity of the human body can be obtained. Knee joint
replacement performed according to the plan obviously has higher
accuracy.
[0171] FIG. 7 shows a schematic graph of a bone-cutting guide
according to an exemplary embodiment of the present application.
Referring to FIG. 7, the bone-cutting guide 107 according to the
embodiment of the present application may comprise a first through
groove 1071 and a second through groove 1073 intersected with the
first through groove 1071, but the present application is not
limited to two through grooves, for example, a plurality of through
grooves distributed at a certain angle may be arranged. According
to some embodiments, the first through groove 1071 and the second
through groove 1073 may be at 90 degrees, but the present
application is not limited thereto. At an executing stage, when the
first through groove 1071 or the second through groove 1073 is
located to be aligned with the bone-cutting plane, the surgeon may
insert the bone-cutting saw into the through groove and manually
perform bone-cutting operation. The first through groove 1071 and
the second through groove 1073 may be formed in a main body 1070 of
the bone-cutting guide 107.
[0172] The general bone-cutting guide only has a single guide
route. The bone-cutting saw changes multiple directions in the
operation only by depending on the motion of the mechanical arm. If
the change angle in multiple directions is large, the motion
posture of the mechanical arm may block the visual field of the
operator or the navigation camera. According to the present
application, the bone-cutting saw may be placed in different
through holes 1071 or 1073 to realize bone-cutting operation in
different directions and at different positions. Therefore, the
mechanical arm may maintain as little motion as possible, such that
the tracer mounted at the operating end of the mechanical arm has a
better visual angle in the space of the navigation camera, and the
posture precision of the tail end of the mechanical arm may be
improved. In addition, the visual field of the operator is not
affected, thus facilitating the smooth progress of the
operation.
[0173] FIG. 8 shows a bone-cutting guide tracer 1111 which may be
arranged at the operating end of the mechanical arm of the surgical
robot according to exemplary embodiment.
[0174] Referring to FIG. 8, the bone-cutting guide tracer 1111
according to the exemplary embodiment may comprise a base and
multiple groups of tracing components.
[0175] According to the exemplary embodiment, the base may comprise
a plurality of first tracing surfaces 3011 and at least one second
tracing surface 3013. The plurality of first tracing surfaces 3011
is located on a side surface of the base, and the at least one
second tracing surface 3013 is located on an end face or a step
surface intersected with the side surface of the base.
[0176] According to the exemplary embodiment, the multiple groups
of tracing components are arranged on the plurality of first
tracing surfaces 3011 and the at least one second tracing surface
3013 respectively. Each group of tracing components may
respectively comprise at least three non-collinear tracing
components 3031. The multiple groups of tracing components are
distributed along a circumferential direction of the base 301.
Among the tracing components 3031 included in the same group of
tracing components, a normal included angle of any two tracing
components 3031 is less than or equal to 20.degree..
[0177] According to the exemplary embodiment, the bone-cutting
guide tracer 1111 is an annular tracer. A main body of the base 301
may be substantially cylindrical or prismatic, comprising a side
surface basically parallel to an axis and two end faces basically
vertical to the side surface. In addition, to reduce the moment of
the operation end, according to some embodiments, the base may be
configured as a stepped tower shape formed by mutually connecting a
plurality of cylinders or prims with decreasing sectional area.
[0178] Multiple groups of tracing device provided by the embodiment
of the present application are arranged along the circumferential
direction of the base, so that a range of the tracing device that
may be identified by an optical position finder is enlarged.
Meanwhile, among the tracing components 3031 included in the same
group of tracing components, the normal included angle of any two
tracing components 3031 is defined to be less than or equal to
20.degree., so that the tracing device is more easily identified by
the optical position finder in the rotation process of the
mechanical arm, whereby the situation that the optical position
finder loses the position of the tracing device during rotation of
the mechanical arm is reduced and the positioning accuracy is
improved.
[0179] In addition, relative to the traditional surgical robot
auxiliary system, the present application adds a knee joint fixator
designated by reference sign 104 in FIG. 2. As shown in FIG. 2, the
knee joint fixator 104 is fixed on an operating table 102.
[0180] The knee joint fixator 104 is described below in detail with
reference to FIG. 9A and FIG. 9B. FIG. 9A shows the overall knee
joint fixator according to an exemplary embodiment of the present
application. FIG. 9B shows a clamp assembly for the knee joint
fixator in FIG. 9A.
[0181] The knee joint fixator shown in FIG. 9A may be configured to
fix the knee joint of the patient. As shown in FIG. 9A, the knee
joint fixator comprises a pedestal 200, a bracket 300, a femur
clamp 400 and a foot clamp 500.
[0182] The pedestal 200 is located at the lowest end of the knee
joint fixing device and provides support for other parts. The
bracket 300 is mounted on the pedestal 200 and comprises a
supporting column 304 to support the knee joint.
[0183] The femur clamp 400 for clamping the femur is mounted on two
sides of the top end of the bracket 300. The femur clamp 400
comprises two groups of clamp assemblies 100 (described in detail
later) and a locking mechanism which may lock guide frames of the
clamp assemblies 100 to the top end of the bracket 300, and may
relatively lock an angle of the guide frames 110 of the clamp
assemblies 100 and the supporting column 304. The locking mechanism
may be selected from the existing cam handle type locking
mechanism.
[0184] The foot clamp 500 for clamping the foot is movably mounted
on the pedestal 200. The foot clamp 500 comprises a foot chassis
501, a foot support 502, two groups of clamp assemblies 100 and a
locking mechanism. The two groups of clamp assemblies 100 are
respectively mounted on two opposite side walls of the foot chassis
501 for clamping anklebones. An orientation of the guide frames 110
of the clamp assemblies 100 relative to the foot chassis 501 may be
locked by the locking mechanism.
[0185] According to an optional solution, the knee joint fixing
device further comprises a tibia clamp 600. The tibia clamp 600 is
mounted on two sides of the top end of the bracket 300 and
comprises two groups of clamp assemblies 100 for clamping the
tibia.
[0186] FIG. 9B is a stereogram of a clamp assembly in the knee
joint fixator shown in FIG. 9A. As shown in the figure, each clamp
assembly 100 comprises a guide frame 110, a sliding block 120, a
distance-adjusting shaft 130 and a pressing head 140.
[0187] The guide frame 110 is long strip-shaped. A through guide
hole 111 is formed in a surface of the guide frame 110. A mounting
hole 113 is formed on an outer side of the guide hole 111 and at
one end of the guide frame 110 and is configured to fixedly mount
the guide frame 110. The sliding block 120 is mounted in the guide
hole 111 and may slide along the guide hole 111. The sliding block
120 is provided with a through shaft hole. The distance-adjusting
shaft 130 is movably mounted in the shaft hole of the sliding block
120, that is, the distance-adjusting shaft 130 may extend or
retract along the axis of the shaft hole. The pressing head 140 is
hinged to an end of the distance-adjusting shaft 130 to tightly
press the bone.
[0188] The knee joint fixator shown in FIG. 9A can completely fix
the femur and/or the tibia in the knee joint replacement operation
so as to reduce accidental injury to other tissues in the operation
process. In addition, the use of the knee joint fixator provides
convenience for more accurate positioning and bone-cutting
operation of the knee joint of the patient. Of course, the present
application is not limited to the knee joint fixator shown in FIG.
9A and may adopt fixing devices with other structures as long as
the lower limb of the patient can be fixed.
[0189] Cutting of the knee joint plane is described below in detail
with reference to FIG. 10.
[0190] In the total knee replacement operation, cutting of the
femur and the tibia, namely bone-cutting operation, is performed
according to the plan after the intraoperative plan is formulated,
and finally, the prosthesis is placed to complete the whole
operation. FIG. 10 is a schematic graph of a prosthesis. As shown
in FIG. 10, the prosthesis contour is determined. To cooperate with
the prosthesis, the tibia of the patient is cut only for one cut in
the replacement operation, corresponding to the distal-end
bone-cutting plane shown in FIG. 10; and the femur is cut for five
cuts, respectively corresponding to a distal-end bone-cutting
plane, a front-condyle oblique bone-cutting plane, a rear-condyle
oblique bone-cutting plane, a front-condyle bone-cutting plane and
a rear-condyle bone-cutting plane shown in FIG. 10. At present,
when the surgical robot cuts the femur, the robot automatically
cuts the distal-end bone-cutting plane according to the
intraoperative plan firstly and then a four-in-one cutting guide
device is mounted on the distal-end bone-cutting plane to complete
operation of other four cuts on the femur. The reason for adopting
the four-in-one cutting guide device is that the current surgical
robot has limited accuracy and is difficult to ensure the accurate
positioning and cutting of each bone-cutting plane. Therefore, the
number of the bone-cutting planes that need to be located is
reduced by a position relationship between the distal-end
bone-cutting plane and other bone-cutting planes. Obviously, for
such cutting scheme, the accuracy of the other four cuts depends on
the distal-end bone-cutting plane. Once the distal-end bone-cutting
plane is positioned and cut inaccurately, errors will occur in
other four bone-cutting planes.
[0191] The present application aims to provide a total knee
arthroplasty robot auxiliary system with higher precision. For
this, numerous measures for improving the precision of the surgical
robot have been taken, for example, as described above, improving
the precision of the intraoperative plan by the dynamic spacing
force line graph, ensuring the positioning and bone-cutting
operation by the knee joint fixator, improving the positioning
accuracy of the bone-cutting guide by the annular tracer of the
bone-cutting guide, etc. It is necessary to drive a pin into the
femur for fixation during mounting of the four-in-one cutting guide
device. The present application abandons the four-in-one device and
adopts five-cut operation on the femur, thus avoiding secondary
injury caused by the fact that the pin is driven into the
femur.
[0192] Specifically, during cutting operation, the first
bone-cutting plane is selected from the plurality of bone-cutting
planes provided from the interaction interface of the man-machine
interaction device 103, so that the mechanical arm 1051 of the
surgical robot 105 is guided, the through groove of the
bone-cutting guide 107 fixed at the operating end of the mechanical
arm is aligned with the first bone-cutting plane, and the
bone-cutting guide 107 is located at the corresponding planned
position. For example, on the interaction interface, the surgeon
may determine the first bone-cutting plane according to the
preoperative plan and the on-site situation. Generally, the surgeon
may select a plane of the tibia corresponding to the distal-end
bone-cutting plane of the prosthesis. After the bone-cutting plane
is selected, the surgical robot 105 controls the mechanical arm
1051 to guide the bone-cutting guide 107 to the planned position
according to the intraoperative plan transmitted by the upper
controller 101. Moreover, the through groove of the bone-cutting
guide 107 is aligned with the first bone-cutting plane, so that the
surgeon may insert the bone-cutting saw into the through groove of
the bone-cutting guide 107 to perform bone cutting.
[0193] After the first bone-cutting plane is cut, the surgeon may
determine the second bone-cutting plane through the interaction
interface of the man-machine interaction device 103 according to
the intraoperative plan and the on-site situation. After the second
bone-cutting plane is selected, the bone-cutting guide 107 is
guided to a new planned position through the motion of the
mechanical arm 1051, and the through groove of the bone-cutting
guide 107 is aligned with the second bone-cutting plane, so that
the surgeon may insert the bone-cutting saw into the through groove
of the bone-cutting guide 107 to perform the second bone-cutting
operation. For example, the second bone-cutting plane may be the
other one of a distal-end bone-cutting plane, a front-condyle
oblique bone-cutting plane, a rear-condyle oblique bone-cutting
plane, a front-condyle bone-cutting plane and a rear-condyle
bone-cutting plane. In a similar way, the positioning and
bone-cutting operation of the bone-cutting guide 107 relative to a
plurality of bone-cutting planes in the total knee joint
replacement operation may be completed through several similar
operations.
[0194] According to some embodiments, after the bone-cutting plane
is selected, mechanical arm simulation is performed first and then
bone-cutting operation is performed. Specifically, based on the
planned data, the mechanical arm 1051 is simulated to be guided in
the interface of the man-machine interaction device 103, so that
the bone-cutting guide 107 arrives at the planned position and the
through grooves of the bone-cutting guide 107 are respectively
aligned with the selected bone-cutting planes. According to the
simulation process, the surgeon may check the prosthesis plan of
the replacement operation and confirm that the mechanical arm 1051
will not interfere or collide with other objects during motion of
the mechanical arm 1051, and may verify positioning of the
mechanical arm 1051.
[0195] According to some embodiments, after the execution of one
bone-cutting plane, the intraoperative plan may be adjusted
according to the specific situation after bone cutting and the
planned data is updated, and then the next bone-cutting plane is
selected from the plurality of bone-cutting planes on the interface
of the man-machine interaction device 103 to perform bone-cutting
operation. The bone-cutting operation at the next cut is adjusted
according to the actual operation situation, so that the subsequent
bone-cutting plane is determined more accurately.
[0196] In one embodiment, a tracer, such as an infrared reflector
or other tracing components, is mounted on the bone-cutting saw.
The navigation camera 1093 acquires position information of the
bone-cutting saw in real time through the tracer on the
bone-cutting saw, and the display screen 1093 displays a relative
position relationship between the bone-cutting saw and the bone of
the patient in real time so as to intuitively guide the
bone-cutting operation of the surgeon.
[0197] In an embodiment, a strain gauge is mounted at a free end of
the bone-cutting saw. The upper controller 101 acquires a bending
variable value of the bone-cutting saw by the strain gauge,
compares the bending variable value with the prestored threshold
value and warns when the variable value exceeds the threshold
value. Through the strain gauge, the parameter of the bone-cutting
saw which is being operated can be ensured to meet the set
precision requirement, and the bone-cutting accuracy can be
improved.
[0198] FIG. 11 shows a control method for a total knee arthroplasty
robot auxiliary system according to an exemplary embodiment of as
shown in present application.
[0199] The control method comprises S10 where a preoperative plan
is generated; S20 where an intraoperative plan is generated; and
S30 where operation of a surgical robot is controlled.
[0200] In S10, the preoperative plan is obtained according to the
acquired CT or MRI image, including prosthesis data such as joint
prosthesis model number and the like, and a preliminary
bone-cutting scheme, etc.
[0201] In S20, the intraoperative plan is generated. Specifically,
an image in the preoperative plan and a knee joint surface contour
of the patient determined are subjected to image registration; knee
joint dynamic spacing force line data at a continuous
flexion-extension angle is acquired; a dynamic spacing force line
data graph is visually displayed; and a prosthesis plan is adjusted
according to the visual display of the dynamic spacing force line
data graph. All the steps have been described above, thus not being
elaborated here.
[0202] In S30, operation is controlled. The adjusted prosthesis
plan is transmitted to the surgical robot and a mechanical arm of
the surgical robot is guided, so that a bone-cutting guide is
located at a planned predetermined position. The bone-cutting guide
is mounted at an operating end of the mechanical arm of the
surgical robot to position the bone-cutting saw. According to some
embodiments, the bone-cutting guide is mounted at the operating end
of the mechanical arm through the bone-cutting guide tracer.
[0203] According to some embodiments, the acquiring knee joint
dynamic spacing force line data at a continuous flexion-extension
angle comprises: acquiring motion track information of the knee
joint in the continuous lower limb flexion-extension process;
calculating a spacing and a force line angle at a continuous lower
limb flexion-extension angle according to the motion track
information.
[0204] According to some embodiments, the adjusting a prosthesis
plan comprises: receiving prosthesis position adjusting information
interacted by a user; recalculating the spacing force line is
recalculated and refreshing the dynamic spacing force line data
graph.
[0205] According to some embodiments, the prosthesis position
information comprises at least one of a varus/valgus angle, an
external/internal rotation angle, a front and back inclination
angle, a vertical translation distance and a transverse translation
distance.
[0206] According to some embodiments, the control method further
comprises visually adjusting the preoperative plan before the
intraoperative plan is generated. As shown in FIG. 2, after being
designed by an engineer, a preoperative plan may be provided to the
surgeon and operated by the surgeon in a surgeon office. Surgeons
visually adjust the preoperative plan according to their medical
experience, for example, they may adjust the prosthesis placing
position including spacing, angle and the like by the man-machine
interaction interface. In addition, in the operating room, before
the operation on the patient, the surgeon may visually adjust the
preoperative plan in advance to design the prosthesis plan as
reasonably as possible.
[0207] According to some embodiments, the control method further
comprises: before controlling operation of the surgical robot
according to the adjusted prosthesis plan, simulating guiding the
mechanical arm in a man-machine interaction interface, so that the
bone-cutting guide arrives at the planned position and a through
groove of the bone-cutting guide is aligned with a corresponding
bone-cutting plane.
[0208] According to some embodiments, one bone-cutting plane is
selected from a plurality of bone-cutting planes before operation
of the surgical robot is controlled according to the adjusted
prosthesis plan, wherein the plurality of bone-cutting planes
include a first bone-cutting plane, a second bone-cutting plane, a
third bone-cutting plane, a fourth bone-cutting plane, a fifth
bone-cutting plane and a sixth bone-cutting plane; and the
mechanical arm is controlled according to the prosthesis plan, so
that a through groove of the bone-cutting guide is aligned with the
selected bone-cutting plane and the bone-cutting guide is located
at a corresponding planned position.
[0209] According to some embodiments, the control method further
comprises: updating planned data; selecting another bone-cutting
plane a plurality of bone-cutting planes; and guiding the
mechanical arm according to the updated planned data, so that a
through groove of the bone-cutting guide is aligned with another
bone-cutting plane and the bone-cutting guide is located at a
corresponding planned position.
[0210] According to some embodiments, the first bone-cutting plane,
the second bone-cutting plane, the third bone-cutting plane, the
fourth bone-cutting plane, the fifth bone-cutting plane and the
sixth bone-cutting plane are respectively one of a tibial
distal-end bone-cutting plane, a femoral distal-end bone-cutting
plane, a femoral front-condyle oblique bone-cutting plane, a
femoral rear-condyle oblique bone-cutting plane, a femoral
front-condyle bone-cutting plane and a femoral rear-condyle
bone-cutting plane.
[0211] FIG. 12 shows a control device for a total knee arthroplasty
robot auxiliary system according to an exemplary embodiment of the
present application.
[0212] The control device comprises a preoperative plan acquisition
module 40, an intraoperative plan acquisition module 50 and an
operation control module 60.
[0213] The preoperative plan acquisition module 40 obtains a
preoperative plan according to the acquired CT or MRT image,
including prosthesis data such as joint prosthesis model number and
the like, and a preliminary bone-cutting scheme, etc.
[0214] The intraoperative plan acquisition module 50 comprises: an
image registration module 51 configured to perform image
registration on a knee joint image in the preoperative plan data
and an intraoperative knee joint; a visual display module 52
configured to display a knee joint image after registration and the
dynamic gap force line data graph; and an adjusting module 53
configured to adjust a prosthesis plan according to the visual
display of the dynamic spacing force line data.
[0215] The operation control module 60 is configured to control
operation of the surgical robot according to the adjusted
prosthesis plan and guide a bone-cutting guide to be located at a
planned predetermined position, wherein the bone-cutting guide is
mounted at an operating end of a mechanical arm of the surgical
robot to locate a bone-cutting saw.
[0216] FIG. 13 shows a block graph of electronic device according
to an exemplary embodiment of the present application.
[0217] The electronic device 800 according to the implementation
manner of the present application is described below with reference
to FIG. 13. The electronic device 800 shown in FIG. 8 is only an
example and in no way limits the functions and application scope of
the embodiment of the present application.
[0218] As shown in FIG. 13, the electronic device 800 is
illustrated in the form of general-purpose computing device.
Components of the electronic device 800 may include, but are not
limited to: at least one processing unit 810, at least one memory
unit 820, a bus 830 connecting different system components
(including the memory unit 820 and the processing unit 810) and the
like.
[0219] The memory unit 820 stores program codes which may be
executed by the processing unit 810, so that the processing unit
810 implements methods according to various embodiments of the
present application.
[0220] The memory unit 820 may include a readable medium in the
form of a volatile memory unit, for example a random access memory
(RAM) unit 8201 and/or a cache memory unit 8202, and may further
include a read only memory (ROM) unit 8203.
[0221] The memory unit 820 may further include a program/utility
8204 with a group (at least one) of program modules 8205. The
program module 8205 comprises, but is not limited to: an operating
system, one or more application programs, other program modules and
program data. Each or a certain combination of these examples may
include implementation of a network environment.
[0222] The bus 830 may represent one or more of several types of
bus structures, including a memory bus or a memory controller, a
peripheral bus, a graphic acceleration port, a processing unit or a
local bus using any of a variety of bus architectures.
[0223] The electronic device 800 may communicate with one or more
external device 8001 (such as touch screens, keyboards, pointing
device, Bluetooth device and the like), and may also communicate
with one or more devices enabling a user to interact with the
electronic device 800, and/or communicate with any device (for
example a router, a modem and the like) enabling the electronic
device 800 to communicate with one or more other computing devices.
The communication may be performed through an input/output (I/O)
interface 850. Furthermore, the electronic device 800 may
communicate with one or more networks (for example a local area
network (LAN), a wide area network (WAN) and/or a public network
such as Internet) through a network adapter 860. The network
adapter 860 may communicate with other modules of the electronic
device 800 through the bus 830. It should be understood that
although not shown in the figure, other hardware and/or software
modules may be used in combination with the electronic device 800,
including but not limited to: a microcode, a device driver, a
redundancy processing unit, an external disk drive array, a RAID
system, a tape driver, a data backup storage system and the
like.
[0224] The present application further provides a computer readable
storage medium. A computer program is stored in the computer
readable storage medium and enables the processor to implement the
above method when executed by the processor.
[0225] The embodiment of the present application further provides a
computer program product. The computer program is operable to
enable the computer to implement part or all of the steps recorded
in the embodiment of the above method.
[0226] Those skilled in the art may clearly understand that the
technical solution of the present application may be implemented by
virtue of software and/or hardware. "Unit" and "module" in the
specification refer to software and/or hardware which can
independently complete or cooperate with other parts to complete
specific functions, wherein the hardware may be a
field-programmable gate array (FPGA), an integrated circuit (IC)
and the like.
[0227] It should be noted that, for the sake of simple description,
the foregoing embodiments of the method are described as a series
of action combinations, but those skilled in the art will recognize
that the present application is not limited by the order of actions
described, certain steps may be carried out in another order or at
the same time according to the present application.
[0228] In the above embodiments, the description of each embodiment
has its own. For parts that are not described in detail in an
embodiment, reference may be made to related description of other
embodiments.
[0229] The embodiments of the present application are described and
explained above in detail. It should be clearly understood that the
present application describes how to form and use specific
examples, but the present application is not limited to any details
of these examples. On the contrary, based on the teachings of
contents disclosed by the present application, these principles can
be applied to many other embodiments.
[0230] Through the description of the exemplary embodiments, those
skilled in the art can easily understand that the technical
solution according to the embodiments of the present application at
least has one or more of the following advantages.
[0231] According to some embodiments, intuitive and flexible
planned basis is provided for surgeons by the dynamic gap force
line data graph, reconstruction of the force line and the
postoperative soft tissue balance are effectively improved, the
surgeons are allowed to adjust the position of the joint prosthesis
and the bone-cutting scheme within the reachable flexion-extension
angle range of the lower limb of the patient, a prosthesis plan
close to the real activity of the human body can be obtained, and
the action comfortability of the patient after the operation is
provided.
[0232] According to some embodiments, the bone-cutting guide
comprises a first through groove and a second through groove
intersected with the first through groove. In this way, the
bone-cutting saw may be placed in different through grooves to
realize bone-cutting operation in different directions and at
different positions, and thus the mechanical arm may maintain as
little motion as possible. Moreover, the occupied operating space
may be reduced and the requirement on the operating environment is
correspondingly reduced. In addition, since the motion range of the
mechanical arm may be reduced, the tracer has a better visual angle
in the space of the navigation camera and the posture precision of
the tail end of the mechanical arm may be improved.
[0233] According to some embodiments, multiple groups of tracing
device provided by the embodiment of the present application are
arranged along the circumferential direction of the base, so that a
range of the tracing device that may be identified by an optical
position finder is enlarged. Meanwhile, a normal included angle of
tracing components included in the same group of tracing components
is defined to be less than or equal to 20.degree., so that the
tracing device is more easily identified by the optical position
finder in the rotation process of the mechanical arm, the situation
that the optical position finder loses the position of the tracing
device during rotation of the mechanical arm is reduced and the
positioning accuracy is improved.
[0234] According to some embodiments, the femur and/or the tibia
can be completely fixed by applying the knee joint fixator in the
knee joint replacement operation, so that accidental injury to
other tissues in the operation process is reduced. In addition, the
use of the knee joint fixator provides convenience for more
accurate positioning and bone-cutting operation of the knee joint
of the patient.
[0235] According to some embodiments, five-cut bone cutting of the
femur may be realized by virtue of the surgical robot auxiliary
system and there is no need to mount a four-in-one cutting guide
device on the femur, thus avoiding secondary injury caused by the
fact that the pin is driven into the femur.
[0236] It should be noted that the technical concept and technical
means in the present application may be applied to knee joint
replacement and may also be applied to wider scenarios: for
example, realizing the technical concept of the dynamic spacing
force line with improved prosthesis plan precision, and may be
applied to other joints; and the technical concept that the
bone-cutting guide is provided with a plurality of through grooves
may be applied to other bone-cutting operations, for example a hip
joint, etc.
[0237] The exemplary embodiments of the present application are
shown and described above in detail. It should be understood that
the present application is not limited to detailed structures,
setting methods or implementation methods described herein; on the
contrary, the present application is intended to cover various
modifications and equivalent arrangements included within the
spirit and scope of the appended claims.
* * * * *